Meds for test 1

Question 1

Common drug therapy for RA:

Answer 1

NSAIDS (short-term use)

DMARDS

Corticosteroids

BRM’s

Other immunosuppressive agents

Question 2

Common drug therapy for OA:

Answer 2

NSAIDS (short-term use)

Acetaminophen

other analgesics

Question 3

celecoxib (Celebrex) (Cox 2 inhibitor) is usually first choice unless patient has

Answer 3

Hypertension

kidney disease

Cardiovascular disease

Question 4

Biological response modifier used for RA:

Answer 4

Etanercept (Enbrel - subQ)

Infliximab (Remicade- single IV infusion over several hrs)

Adalimumab (Humira- subQ)

Anakinra (Kineret- subQ)

Abatacept (Orencia- IV)

Rituximab (Rituxan- IV)

Golimumab (Simponi- subQ)

Tocilizumab (Actemra- IV)

Question 5

First-line disease modifying antirheumatic drugs (3)

Answer 5

Methotrexate (Rheumatrex)

Leflunomide (Arava)

Hydroxychloroquine (Plaquenil) -antimalarial, watch for retinal damage

Question 6

Prednisone (deltasone) is a

Answer 6

glucocorticosteroid, fast acting anti-inflammatory and immunosuppressive)

Question 7

Bisphosphonates (abr)

Answer 7

common drug used for osteoporosis

alendronate (Fosamax)

Ibandronate (Boniva)

risedronate (Actonel, Atelvia)

commonly used for prevention and treatment of osteoporosis

Question 8

Drug therapy for osteoporosis

Answer 8

Calcium supplements

Bisphosphonates

Estrogen agonist/antagonist (Raloxifene- Evista)

Question 9

Drug therapy for Paget’s disease

Answer 9

NSAID (ibuprofen)

Oral BP’s

Calcitonin

Question 10

Normal ESR labs:

Answer 10

male: up to 15 mm/hr

Female: up to 20 mm/hr

Question 11

Normal HsCRP labs:

Answer 11

< 1.0 mg/dl or <10.0 mg/L

Question 12

Normal serum complement C3 & C4 labs

Answer 12

Total: 30-75 units/mL

C3: 75-175 mg/dL;

C4: 22-45 mg/dL

Question 13

Normal SPEP labs:

Answer 13

6.4-8.3 g/dL

Question 14

Drugs that can cause Osteoporosis:

Answer 14

Corticosteroids

Anti-epileptic drugs (phenytoin)

Barbiturates (phenobarbital)

Ethanol (alcohol)

Drugs that induce hypogonadism

High levels of thyroid hormone

Cytotoxic agents

Loop diuretics

Immunosuppressants

Question 15

Osteoporosis clinical manifestations:

Answer 15

dowager’s hump or kyphosis of dorsal spine

decreased height

back pain

fractures

no definitive lab tests

Question 16

Osteomalacia clinical manifestations:

Answer 16

early stage- non specific

muscle weakness, bone pain

muscle cramping- hypocalcemia

Question 17

Musculoskeletal manifestations of Paget’s disease

Answer 17

bone and joint pain that is aching, poorly described, and aggravated by walking

low back pain and sciatic nerve pain

bowing of long bones

loss of normal spinal curvature

enlarged, thick skull

pathologic fractures

Question 18

Skin manifestations of Paget’s disease:

Answer 18

flushed, warm skin

Question 19

Other manifestations of Paget’s disease:

Answer 19

apathy, lethargy, fatigue

hyperparathyroidism

gout

urinary or renal stones

heart failure from fluid overload

Question 20

Acute osteomyelitis key features

Answer 20

fever

swelling around area

erythema of affected area

tenderness of area

bone pain that is constant, localized and pulsating, intensifies with movement

Question 21

Chronic osteomyelitis features

Answer 21

foot ulcers (MOST COMMON)

Sinus tract formation

localized pain

drainage from affected area

Question 22

Osteomyelitis diagnostics

Answer 22

CBC

ESR

Blood culture/wound culture

x-rays/CT scan

MRI

Biopsy

Question 23

Osteomyelitis interventions

Answer 23

Non-surgical

• IV antibiotics (Vancomycin)
• PICC line
• Wound care
• Hyperbaric Oxygen therapy

surgical:

sequestrectomy (may be performed to deride the necrotic bone)
amputation